Vaping is a risk factor for spontaneous pneumothorax: Two cases

We present two male patients age 15 and 16 who had a spontaneous pneumothorax after vaping and were initially treated with tube thoracostomy placement. Both patients had recurrences requiring surgical intervention and have been recurrence-free since. This is the first known report of vaping and its association with spontaneous pneumothorax. A comprehensive smoking history that includes vaping is important in patients presenting with suspected pneumothoraces as it can lead to earlier cessation interventions, help prevent recurrence, and raise suspicion for pneumothorax in patients presenting without severe symptoms. As more studies demonstrate vaping-associated lung injury, we advocate for stricter standards of quality control for electronic cigarettes and encourage legislators to do the same.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research

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A 46-year-old black woman with a history of endometriosis presented with right-sided sciatica, right shoulder pain and persistent cough. She had a history of severe endometriosis and fibroids with previous laparoscopic supracervical hysterectomy and bilateral salpingectomy performed at an outside facility one year earlier. Three weeks prior to presentation, she had a spontaneous right pneumothorax which was managed with a tube thoracostomy. Transvaginal ultrasound demonstrated bilateral endometriomas and repeat computed tomography scan indicated a recurrent right apical pneumothorax.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Original Article Source Type: research
​Pediatric needle thoracostomy is a rarely performed procedure, but one must know the technique and be prepared to perform it. It can be life-saving in the face of a tension pneumothorax. This is a simple procedure, but a few procedural fine points can guarantee success and safety.Adult Needle ThoracostomyWe have learned only relatively recently that most adult needle thoracostomies fail to accomplish their mission. A 5 cm angiocatheter inserted at the second intercostal space on the midclavicular line has been the Advanced Trauma Life Support guidelines recommendation for at least a decade. Unfortunately, we now know th...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Authors: Sheldon RR, Do WS, Forte DM, Weiss JB, Derickson MJ, Eckert MJ, Martin MJ Abstract INTRODUCTION: Tension pneumothorax is a common cause of preventable death in trauma. Needle decompression is the traditional first-line intervention but has high failure rates. We sought to evaluate the effectiveness and expedience of needle thoracostomy, surgical tube thoracostomy, and Reactor™ thoracostomy - a novel spring-loaded trocar insertion device. MATERIALS AND METHODS: Yorkshire swine underwent controlled thoracic insufflation to create tension pneumothorax physiology for device comparison. Additional exp...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
​The value and importance of our specialty branching out into tactical emergency medicine are not widely discussed, but it can be rewarding to work with law enforcement. Tactical emergency medicine has expanded rapidly over the past two decades. The American College of Emergency Physicians even has an active tactical emergency medicine section. (http://bit.ly/2Dt1spl.) Its goal is to provide a forum for emergency physicians with interest or expertise in tactical medicine and to share information with the college and other organizations. Fellowships in tactical emergency medicine have been developed as part of academ...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Authors: Şahan E Abstract Phenothiazines like antipsychotics have been known to cause neutropenia, but this has been reported very rarely with haloperidol. A 20-year-old male patient admitted to emergency service (emergency room) with shortness of breath, chest pain, and anger. He was diagnosed with pneumonia and prescribed moxifloxacin. After 2 days with antibiotic, he readmitted. Left lung pneumothorax was detected, and thorax computerized tomography was requested. However, he opposed and beated one of the hospital officials. The diagnosis of manic episode due to antibiotic moxifloxacin was considered. The tube ...
Source: Indian Journal of Psychiatry - Category: Psychiatry Tags: Indian J Psychiatry Source Type: research
ConclusionBilateral thoracic trauma has comparable patterns of presentation, choices of investigation, strategies of management, predictors of the outcome, morbidity and mortality with unilateral chest trauma.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Conclusion A cluster of clinical signs with subcutaneous emphysema and refractory pneumothorax with air leak of the thoracotomy tube is indicative of bronchial injury. Endotracheal intubation should be postponed in these cases until after thoracostomy tube placement, if possible. Placing a retraction suture during repair is a maneuver that helps to occlude the defect and keep the remaining tracheobronchial lumen open at the same time to establish crucial ventilation of the contralateral lung. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  ...
Source: European Journal of Pediatric Surgery Reports - Category: Surgery Authors: Tags: Case Report Source Type: research
This study examined the outcomes of needle aspiration and closed thoracostomy in first episodes of PSP requiring intervention. Methods: This study was a randomized, prospective, single-center trial conducted between December 2015 and August 2016. Patients of all ages with a documented first episode of PSP who were unilaterally affected, hemodynamically stable, and had a pneumothorax measuring over 25% in size were included. Patients with underlying lung disease, severe comorbidities, bilateral pneumothorax, tension pneumothorax, recurrent pneumothorax, traumatic pneumothorax, and pregnancy were excluded. Patients were ...
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
​BY KYLE NADEL &PAUL SILKA, MDThe older woman was short of breath and experiencing epigastric abdominal pain. She was an ex-smoker in her mid-70s with a past medical history of COPD, pulmonary fibrosis, breast cancer, and intermittent home oxygen. Her symptoms had started gradually a few hours earlier.The patient's vital signs on arrival were a blood pressure of 122/80 mm Hg, heart rate of 101 bpm, respiratory rate of 42 bpm, and 91% SpO2 on 2 L/min via nasal cannula. She was tachypneic with accessory muscle use, and breath sounds were clear bilaterally but diminished on the left hemithorax.The patient was promp...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuriti...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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